Some children with intestinal malrotation are born with other associated conditions, including:. An intestinal blockage can prevent the proper passage of food. So one of the earliest signs of malrotation and volvulus is abdominal pain and cramping, which happen when the bowel can't push food past the blockage. Vomiting is another symptom of malrotation, and it can help the doctor determine where the obstruction is. Vomiting that happens soon after the baby starts to cry often means the blockage is in the small intestine; delayed vomiting usually means it's in the large intestine.
The vomit may contain bile which is yellow or green or may resemble feces. If volvulus or another intestinal blockage is suspected, the doctor will examine your child and then may order X-rays , a computed tomography CT scan , or an abdominal ultrasound. The doctor may use barium or another liquid contrast agent to see the X-ray or scan more clearly. The contrast can show if the bowel has a malformation and can usually find where the blockage is.
Adults and older kids usually drink barium in a liquid form. Infants may need to be given barium through a tube inserted from the nose into the stomach, or sometimes are given a barium enema, in which the liquid barium is inserted through the rectum. Treating significant malrotation almost always requires surgery. The timing and urgency will depend on the child's condition. If there is already a volvulus, surgery must be done right away to prevent damage to the bowel.
Any child with bowel obstruction will need to be hospitalized. A small camera then sends a video image of the intestinal lining to a computer screen for a close view of the affected area. Cecal volvulus can be also diagnosed with imaging of the upper or lower GI. These tests will show whether the cecum is out of place and inflated with trapped air. Colon volvulus treatment Colon volvulus is a surgical emergency that requires immediate repair to return normal blood flow.
For sigmoid volvulus, the doctor may use a sigmoidoscope to untwist the colon; the volvulus may or may not recur. In some cases, an intestinal resection is needed. With this, the doctor removes the damaged part of the colon and reattaches the healthy ends. This can prevent volvulus from recurring. For cecal volvulus, a procedure called cecopexy will reposition the cecum and attach it to the abdominal wall.
If the cecum is seriously damaged, intestinal resection surgery will be performed. Diagnosis and Treatment of Sigmoid Volvulus Prompt diagnosis and appropriate treatment of sigmoid volvulus generally lead to a successful outcome.
Flexible sigmoidoscopy. This test is used to look inside the rectum and lower colon. Infants and children may be given a sedative to help them fall asleep for the test. For the test, the person will lie on a table while the doctor inserts a flexible tube into the anus.
A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctor can see sigmoid volvulus. Children and adults can usually go back to their normal diet after the test, though cramping or bloating may occur during the first hour after the test.
Cecal Volvulus Cecal volvulus is twisting of the cecum and ascending colon. Symptoms of Cecal Volvulus More commonly seen in people ages 30 to 60, cecal volvulus may be caused by abdominal adhesions, severe coughing, or pregnancy. Colon and small intestine The small intestine and colon are components of your digestive tract, which processes the foods you eat. Request an Appointment at Mayo Clinic. Intussusception Open pop-up dialog box Close. Intussusception Intussusception is a rare, serious disorder in which one part of the intestine slides inside an adjacent part.
Share on: Facebook Twitter. Show references Feldman M, et al. Intestinal obstruction. Elsevier; Accessed Dec. Merck Manual Professional Version.
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